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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0939

O36.0939

Billable

Maternal care for other rhesus isoimmunization, third trimester (other fetus)

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/08/2025

Code Description

ICD-10 O36.0939 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, third trimester (other fetus).

Key Diagnostic Point:

Maternal care for rhesus isoimmunization in the third trimester involves monitoring and managing the health of the mother and fetus when the mother has developed antibodies against the Rh factor, which can lead to hemolytic disease of the newborn. This condition is particularly concerning when the fetus is Rh-positive and the mother is Rh-negative. In the third trimester, careful surveillance is critical as fetal complications such as growth restriction, fetal distress, and anemia can arise. The management may include serial ultrasounds to assess fetal growth and well-being, non-stress tests to monitor fetal heart rate patterns, and possibly intrauterine transfusions if severe anemia is detected. The healthcare team must document maternal antibody levels, fetal monitoring results, and any interventions performed to ensure comprehensive care and accurate coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of isoimmunization and their implications.
  • Understanding the timing and implications of interventions in the third trimester.
  • Monitoring for fetal complications such as growth restriction and distress.
  • Documenting maternal and fetal health status accurately.

Audit Risk Factors

  • Inadequate documentation of maternal antibody status.
  • Failure to document fetal monitoring results.
  • Omission of interventions performed during care.
  • Misclassification of the fetus's Rh status.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal health, fetal monitoring, and interventions.

Common Clinical Scenarios

Management of Rh isoimmunization, monitoring for fetal growth restriction, and addressing fetal distress.

Billing Considerations

Accurate coding requires thorough documentation of maternal and fetal assessments.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors and interventions.

Common Clinical Scenarios

Complex cases involving multiple fetal assessments and interventions for isoimmunization.

Billing Considerations

High-risk pregnancies necessitate detailed tracking of maternal and fetal health metrics.

Coding Guidelines

Inclusion Criteria

Use O36.0939 When
  • Follow official ICD
  • CM guidelines for obstetric coding, ensuring that the code reflects the specific circumstances of maternal care and fetal conditions
  • Documentation must support the diagnosis and any interventions performed

Exclusion Criteria

Do NOT use O36.0939 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76801CPT Code

Ultrasound, pregnant uterus, transabdominal, real-time with image documentation

Clinical Scenario

Used for monitoring fetal growth and well-being in cases of isoimmunization.

Documentation Requirements

Document indications for ultrasound and findings.

Specialty Considerations

Obstetricians should ensure that ultrasound findings are clearly linked to maternal conditions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of maternal-fetal health documentation and enhancing the ability to track outcomes related to isoimmunization.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of maternal-fetal health documentation and enhancing the ability to track outcomes related to isoimmunization.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of maternal-fetal health documentation and enhancing the ability to track outcomes related to isoimmunization.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding O36.0939 accurately?

Accurate coding of O36.0939 is crucial for ensuring appropriate maternal care and monitoring of fetal health. It impacts clinical management decisions and reimbursement for services provided.